培训课件-糖尿病患者的微血管并发症.ppt

* Key Points It is essential that we recognize and manage neuropathy early and understand that symptomatic diabetic neuropathy can be treated. Keep in mind that as much as 50% of diabetic peripheral neuropathy may be asymptomatic, and the need for patient education is vital if we are to help our patients prevent foot injuries and avoid the need for amputations. Considerable morbidity/mortality is seen from undiagnosed cardiovascular autonomic neuropathy. * Key Points One of the primary messages concerning diabetic neuropathies is that they affect different parts of the nervous system that present with a variety of the clinical manifestations associated with motor, sensory and/or autonomic symptoms. Secondly, it is important that all patients with diabetes are screened for neuropathy at diagnosis particularly in patients with type 2 diabetes and annually thereafter, and that more frequent foot inspection is recommended if neuropathy has been established. Finally, educating our patients about the importance of foot care can reduce their risk for foot ulcers and amputations. * Key Points To summarize: microvascular complications are common in patients with type 1 and type 2 diabetes. Annual screening for retinopathy using retinal eye exams, for nephropathy using UACR, and for neuropathy by assessing the patient and doing a physical examination allows us to identify these complications early on and begin appropriate interventions. In addition, good metabolic control of glucose levels and blood pressure, using a combination of lifestyle interventions and pharmacologic therapy including insulin can either prevent the onset – or delay the progression or intensity – of each of these diabetes-related microvascular and neuropathic complications. * * Key Points There are advantages and disadvantages to the various means of analyzing microalbuminuria. Random spot collection is easy to perform, and usually provides accurate information. First void or morni